Clinical review: Dr. Samreen Ejaz, BDS, RDS ·
Direct and indirect capping
Indirect capping is for decay that has come close to the nerve but hasn’t reached it. We remove the decay and put a protective layer over the thin area. Direct capping is for when the nerve is just exposed, and we cover that spot with a protective material. MTA (mineral trioxide aggregate) is one material we use for this. Both only work if the nerve is still healthy enough.
Is your tooth suitable?
The kind of pain you’ve had matters, along with what we see in the exam, the X-ray and what we find once we start. Whether it’s a milk tooth or an adult tooth, how young the tooth is, the size of any exposure and whether we can seal it well all count. If the nerve is too damaged, you may need a different nerve treatment, a root canal or an extraction instead.
The filling on top matters too
After capping, the tooth needs a well-sealed filling over it. If that seal leaks, germs can get back in, however good the capping material is. Sometimes a temporary filling goes in first. Dr. Samreen will explain whether it’s all done in one visit or in stages, and how we’ll keep an eye on the tooth.
Check-ups afterwards
We’ll want to see the tooth again to ask about symptoms and, where needed, take an X-ray. Call us if you get pain that starts on its own, throbbing at night, swelling, or if the filling comes out. We try to keep the nerve alive when we can, but some teeth still need a root canal later if they don’t settle.
BEFORE YOUR APPOINTMENT
Questions about direct and indirect pulp capping with mta
Will MTA stop me needing a root canal?
Not for certain. It depends on how healthy the nerve is and how well the tooth heals and stays sealed.
Can every exposed nerve be capped?
No. Milk teeth and adult teeth are treated differently, and the cause of the exposure matters. Dr. Samreen will explain why capping does or doesn’t suit your tooth.
Does it hurt?
We numb the tooth first. It may feel a bit sensitive for a few days afterwards, which usually settles. Pain that keeps getting worse needs a check.
This is general information. What’s right for your tooth depends on what Dr. Samreen finds when she examines it.
Background reading: AAPD: pulp therapy guidance. These are overseas sources, so their prices and rules don’t apply here.